Motivational factors influencing nurses to undertake postgraduate hospital-based education.

Specialist postgraduate education improves patient health outcomes, and assists in meeting the emerging specialisation of nursing practice. The aim of this study was to investigate the motivational factors that influence nurses' engagement with hospital-based postgraduate education. The research design was descriptive and exploratory, using a survey method. The survey consisted of demographic details, the Participation Reasons Scale (PRS) and open-ended questions. Thirty-four participants (100%) completed the survey. Of the PRS extrinsic and intrinsic factors, Professional Improvement and Development (Factor 1) and Professional Service (Factor 2), both intrinsic factors, ranked the highest. Therefore, this study identified that intrinsic motivation factors influenced engagement with postgraduate specialty programs for early career nurses. These results highlight the importance of intrinsic motivation factors for a nursing workforce and how this can potentially drive behaviour and decision making. A better understanding of motivation factors across a nurse's career could lead to educational strategies that optimise postgraduate program engagement to better support healthcare delivery and a culture of lifelong learning.

A Retrospective Study Investigating: Factors associated with mode of arrival and emergency department management for patients with acute stroke.

BACKGROUND: Presentation by ambulance to the emergency department is critical for stroke patients to receive time dependent treatments. However, little is known of the factors that influence presentation by ambulance. METHODS: Retrospective analysis of all patients with an emergency department medical diagnosis of stroke who presented to one of three Victorian emergency departments over a three-year period (2011-2013). A multivariable model was used to investigate demographic characteristics (including triage assessment category, triage identified as stroke, time to CT, and time to diagnosis within the emergency department) as predictors of arrival by ambulance. RESULTS: 3548 stroke patients were identified; mean age was 70 years, 53% were males, and 92% had an ischemic stroke. Arrival by ambulance occurred in 71% (n=2509) with arrival by private transport accounting for 29% (n=1039) of patients. Factors significantly associated with arrival by ambulance were older age (p=<0.001), being born in Australia (p=<0.001), and speaking English in the home (p=0.003). Arrival by ambulance was independently associated with rapid stroke care in the emergency department, arrival within 2h from symptom onset, attending an advanced stroke service (access to thrombolysis), triaged for stroke, medical assessment within 25min and referral for CT within 45min. CONCLUSION: In this Australian multicenter study, it was identified that patients who arrived by ambulance received faster acute stroke care within the emergency department. Public health education which targets patients who are younger and from a non-English speaking background is needed as these demographics were not associated with timely arrival by ambulance to the emergency department.